| NPI | 1861752842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN ROSSER Co Owner 414-791-8480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 3321) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2012-05-23 |